Reduction surgeries for delayed cases with isolated blowout fractures.

Abstract

To show the effectiveness of endoscopic reduction surgeries for delayed cases with blowout fractures, and to determine the cause of persisting diplopia based on surgical findings. Retrospective study. Between 1997 and 2006, 114 patients with isolated blowout fractures underwent surgery. In 6 of 114 patients, there were delayed cases in which over 3 months had elapsed since the initial trauma. For persisting diplopia, surgeries were performed using an endoscopic endonasal approach. Adhesion between the protruded periorbita and the paranasal sinus mucosa was remarkable in the delayed cases. Dissection of the adhesion and removal of the bone fragments were performed. The ocular motility improvement was confirmed by intraoperative eye traction tests. Postoperatively, diplopia disappeared in five patients. Endoscopic reduction surgeries for delayed cases are available in the treatment of blowout fractures. The main cause of diplopia was determined to be the adhesion.